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Individual

CARLA DENISE BERRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LVN

Contact information

Practice address
3507 E HIGHWAY 350, BIG SPRING, TX 79720-0493
(432) 213-6146
Mailing address
114 LINCOLN AVE, BIG SPRING, TX 79720-4820
(432) 213-6146
(432) 267-5116

Taxonomy

Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
095789
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
95789
LVN LICENSE NUMBER
TX
Enumeration date
09/05/2018
Last updated
09/05/2018
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